The economic impact of stroke in Australia – Deloitte Access Economics report for the National Stroke Foundation – 17 March 2013

Posted on March 19, 2013. Filed under: Health Economics, Neurology | Tags: , , |

The economic impact of stroke in Australia – Deloitte Access Economics report for the National Stroke Foundation – 17 March 2013

“The bleak future of stroke revealed: over 700,000 survivors and counting.

The number of stroke survivors in Australia will grow to over 700,000 within 20 years, representing a true “social and economic catastrophe” unless Government commit to finally funding the nation’s second biggest killer and a leading cause of disability, according to the National Stroke Foundation.

Launching a new report in Melbourne today, Stroke Foundation chief executive Erin Lalor said despite the fact that stroke had been a National Health Priority Area since 1996 it had been systematically neglected by successive governments since that time.

“This report has shown us the high price Australia will pay for that neglect,” Dr Lalor said.

The Deloitte Access Economics Report, “The economic impact of stroke in Australia”, was commissioned by the National Stroke Foundation in 2012 and provides the first updated figures on the incidence, prevalence and cost of stroke in almost a decade.”

… continues on the site

Deloitte Access Economics Report

Deloitte Access Economics Report Summary 2013

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Sentinel Stroke National Audit Programme (SSNAP) Acute organisational audit report Public Report for England, Wales and Northern Ireland – December 2012

Posted on January 4, 2013. Filed under: Neurology | Tags: |

Sentinel Stroke National Audit Programme (SSNAP) Acute organisational audit report Public Report for England, Wales and Northern Ireland – December 2012

Prepared by Royal College of Physicians, Clinical Effectiveness and Evaluation Unit on behalf of the Intercollegiate Stroke Working Party

“This is the first report published under the auspices of the new national stroke audit, the Sentinel Stroke National Audit Programme (SSNAP). It publishes national and hospital level findings on the organisation of stroke services, in particular acute care organisation, specialist roles, staffing, TIA (mini stroke) services, communication between staff groups and with patients and carers, and pathway at discharge. The results reflect the organisation of stroke services as of 2 July 2012.

The report findings enable the organisation of stroke services at national level to be compared with national standards outlined in the fourth edition of the National Clinical Guideline for Stroke (2012) published by the Intercollegiate Stroke Working Party and, the NICE (National Institute for Health and Clinical Excellence) Clinical Guideline, the National Stroke Strategy 2007 and the NICE Quality Standard for Stroke (2010).”

… continues

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National Stroke Audit Rehabilitation Services Report 2012 – National Stroke Foundation – 3 November 2012

Posted on November 6, 2012. Filed under: Neurology | Tags: , |

National Stroke Audit Rehabilitation Services Report 2012 – National Stroke Foundation – 3 November 2012

Media release:  Many stroke rehabilitation services “remain substandard”: Report

“Some critical stroke rehabilitation services are either unavailable or “substandard” for many patients because of inadequate staffing, education and resources in our hospitals, according to a new report that examines inpatient stroke rehabilitation services in Australia.

The findings are released just days after the nation’s first stroke summit, where 70 survivors and carers from across Australia went to Parliament House in Canberra to demand better stroke awareness, funding, resources, care and support in Australia. The stroke summit, held at Parliament House in Canberra over two days this week (30-31 October), endorsed a Call to Action for stroke and outlined eight areas that urgently need improvement. They include better preparation to prevent stroke, better treatment for those who have had a stroke and better support so people can recover from their stroke.

The National Stroke Audit Rehabilitation Services Report 2012, released today, is a survey of 111 hospitals and 2821 stroke patients and represents more than 40 per cent of all Australian stroke patients admitted for inpatient rehabilitation in the 12-month period from 1 January 2011 to 31 December 2011.

Conducted by the National Stroke Foundation, the audit has made recommendations for better psychological services, discharge planning, rehabilitation coordination and family involvement in stroke recovery to be available to every stroke patient.”

… continues

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Pathways of Care for People with Stroke in Ontario Core – Canadian Institute for Health Information – 12 July 2012

Posted on July 17, 2012. Filed under: Health Mgmt Policy Planning, Neurology | Tags: |

Pathways of Care for People with Stroke in Ontario Core – Canadian Institute for Health Information – 12 July 2012

“This report provides information on pathways of stroke care in Ontario over a four-year period, by following individuals being treated for stroke across hospital settings; including emergency department, acute care, inpatient rehabilitation and complex continuing care. The report sheds light on some important transition points in a stroke patient’s hospital care and on how well the system is integrated and functions for patients. It also identifies key areas where improvements in stroke care can be considered. ”

Media release: Earlier diagnosis, improved flow across care settings key to timelier stroke care in Ontario. Study finds room for improvement in identification and treatment of stroke patients – 12 July 2012

“The number of stroke deaths is declining in Ontario and the rest of Canada, due in part to better management and treatment of the disease. However, a new study released today by the Canadian Institute for Health Information (CIHI) shows that there may still be room for improvement in the early diagnosis and treatment of stroke patients. For example, the study found that about 1 in 10 Ontario stroke patients seen in a hospital emergency department (ED)—representing more than 5,000 cases over a four-year-period—was documented as having had a stroke only after being admitted to a hospital ward.

The study found that these patients had no stroke or stroke symptoms (such as headache or dizziness) listed on their ED records and were less likely to have received a brain imaging scan during the course of their emergency stay than other stroke patients. Best practice recommends that suspected stroke patients should receive brain scans within one hour of their arrival in the ED to identify the type of stroke and appropriate course of treatment.

“Carrying out rapid assessments and confirming that a person has had a stroke most often begin in the ED. It is a coordinated effort among many providers and can present a challenge,” explains Dr. Paul Ellis, emergency physician at the University Health Network. “But the earlier this is done, the sooner appropriate treatment can begin and the greater the chances a patient can recover.” ”

… continues on the site

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Mind the gap: ways to enhance therapy provision in stroke rehabilitation – NHS Improvement – 2011

Posted on December 13, 2011. Filed under: Neurology, Rehabilitation | Tags: , |

Mind the gap: ways to enhance therapy provision in stroke rehabilitation – NHS Improvement – 2011

“Ways to enhance therapy provision in stroke rehabilitation This document explores some of the different models adopted by therapy services to deliver more rehabilitation and provides further detail about 45 minutes, process and outcomes.”
 
Contents
Introduction
National guidelines
Who can deliver more rehabilitation?
When – a seven day service?
How long – getting more out of the whole week?
Where can more therapy make a difference?
How – bridging the gap?
Conclusions
References
Case studies

Practical principles for improving stroke care 

1 – Improving psychological care after stroke 

2 – Developing an early supported discharge service 

 3 – Improving access to CT scanning 

4 – Transient Ischaemic Attack (TIA) 

5 – How to establish joint care planning 

6 – How to manage reviews for stroke survivors 

7 – Being the best in acute stroke 

8 – Developing a community stroke service

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Psychological care after stroke: improving stroke services for people with cognitive and mood disorders – NHS Improvement – 23 August 2011

Posted on August 29, 2011. Filed under: Neurology | Tags: |

Psychological care after stroke: improving stroke services for people with cognitive and mood disorders – NHS Improvement – 23 August 2011

This new publication from NHS Improvement is intended to be a pragmatic guide for services who would like to improve psychological support for people with stroke. The target audience is clinical staff working in stroke services who would like to make local improvements but also stroke networks, SHA leads and commissioners of stroke services interested in large scale improvement in psychological support after stroke.”

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UK Carotid Endarterectomy Audit. Round 3 Public Report – Royal College of Physicians – June 2011

Posted on June 29, 2011. Filed under: Neurology | Tags: , |

UK Carotid Endarterectomy Audit. Round 3 Public Report – Royal College of Physicians – June 2011

“This new report (2011), funded by the Healthcare Quality Improvement Partnership (HQIP), presents the latest finding from Round 3 of the National Carotid Interventions Audit. The audit focussed on the process and outcomes of patients undertaking carotid endarterectomy between 1st October 2009 and 30th September 2010. It covers many of the aspects of the pathway, from the characteristics of the patient, the key delays prior to surgery, the surgery itself and any post operative outcomes.”

“Foreword
The increasing public expectation of early referral and high quality stroke management can only be met by clinicians demonstrating that the care provided is improving in line with evidence based standards. The carotid intervention audit, a joint audit by the Vascular Society of Great Britain & Ireland and the Royal College of Physicians of London, now reports the results of surgical care against national standards for the third time. This report contains both good news and aspirations for improvement. Round three sees the highest level of participation and recorded cases in this national audit since its inception. Along with increasing participation, there are further reductions in the time between symptoms, referral and treatment.

Whilst these improvements are good news for patients and clinicians, there is some way to go before the surgical component of the stroke pathway can be regarded as mature. The NICE standard of 14 days from symptom to treatment is not yet achieved and the National Stroke Strategy target of 48 hours by 2017 looks like a major challenge. The clinical community needs to collectively re-double its efforts and refine the pathway of care. This will require an increased awareness of the importance of the symptoms of impending stroke and a commitment to rapid referral, investigation and treatment. NHS organisations will need to ensure rapid access to clinicians, imaging and surgical teams. Clinical teams will need to recognise TIA as an emergency requiring a rapid response to deliver high quality care in a timely manner.”

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Six-month review after stroke – South London Cardiac and Stroke Network

Posted on June 29, 2011. Filed under: Neurology | Tags: |

Six-month review after stroke – South London Cardiac and Stroke Network

“Stroke is a long term condition. As such, survivors experience changes in their needs over time. Reviews can help ensure patients and carers receive appropriate support and access to services as their needs require.”

“There is clearly a strong onus on commissioners to establish robust review processes for stroke patients. However, the lack of evidence to guide the delivery of these reviews raises many questions: What should a review consist of? Who should lead the review? How should it be delivered? What are the benefits? What are the resource implications?
This guidance therefore seeks to answer these questions, focusing primarily on the six month review due to its inclusion in the ASI programme. This work has been informed by patient and carer engagement activities that have been undertaken in South London, combined with feedback from service models piloted and implemented elsewhere, and work undertaken by the national Stroke Improvement Programme (SIP) team.”

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The Quality of Stroke Care in Canada – Canadian Stroke Network – 2011

Posted on June 21, 2011. Filed under: Neurology | Tags: |

The Quality of Stroke Care in Canada – Canadian Stroke Network – 2011

Extract from the executive summary

“Stroke is a leading cause of death and adult disability. Of all chronic diseases in Canada, stroke is among the most impactful. Sixty per cent of people who have a stroke report that they need help afterwards and 80% have restrictions to their daily activities. In 2005, the Canadian Stroke Strategy set out to ensure every province in Canada was  organized to deliver the best possible stroke care. Over six years, progress has been achieved nation-wide (Appendix A).

Despite the impact of stroke on Canadians and the progress to date, there has never been a comprehensive pan-Canadian report on the quality of stroke care. For this reason, the Canadian Stroke Network collected data representing 38,210 patients admitted with stroke from 295 hospitals across Canada over the period 2008-2009. This data, supplemented with data from national health databases, resulted in The Quality of Stroke Care in Canada. The purpose of this report is to describe the quality of stroke care being provided to Canadians and to make recommendations on how it may be improved. Key findings and recommendations from The Quality of Stroke Care in Canada are described below.”  … continues

 

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National Sentinel Stroke Audit 2010 – Royal College of Physicians – May 2011

Posted on May 20, 2011. Filed under: Neurology | Tags: , |

National Sentinel Stroke Audit 2010 – Royal College of Physicians – May 2011

“Stroke care still improving but concerns remain
The final report of the National Sentinel Stroke Audit shows that care for patients with stroke is still improving 12 years after the start of the audit. 88% of patients spent at least some time on a stroke unit which is excellent progress from 74% in 2008.  Patients on stroke units have better outcomes than those admitted to and treated on general wards.

The audit, commissioned by the Healthcare Quality Improvement Partnership (HQIP), was carried out on behalf of the Intercollegiate Stroke Working Party by the Royal College of Physicians’ Clinical Standards Department, and covers 100% of eligible hospitals in England, Wales and Northern Ireland.”

Report

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Videoconference consultants boost emergency stroke care – 16 February 2011

Posted on February 17, 2011. Filed under: Neurology, Rural Remote Health, Telehealth | Tags: |

Videoconference consultants boost emergency stroke care.  Allowing consultants to order drugs remotely is saving lives and money, according the medical lead of the NHS Stroke Improvement Programme – 16 February 2011

“Dr Damian Jenkinson said that letting groups of hospitals share stroke consultants, who use videoconferencing to examine patients and view brain scans, increases the use of clot-busting drugs.

There are too few consultants to provide round-the-clock cover at every major hospital in person, he told the Mobile and Wireless Healthcare conference in Birmingham: “We need network solutions to make this happen.”

Consultants aim to use the clot-busting drugs within three hours of a stroke taking place, as they help arrest the rapid death of brain cells caused by the condition.

Jenkinson, who is national clinical lead for the NHS Stroke Improvement Programme, said Lancashire and Cumbria had calculated that it would be able to provide the drugs to 400 patients from the 4,000 stroke admissions the area makes each year, rather than 20 as at present. In doing so it would save £2m annually, in return for one-off spending of £285,000 and annual costs of £115,000, with the savings including reduced hospital stays.”

…continues on the site

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Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke – Agency for Healthcare Research & Quality [US] – technical brief published 18 January 2011

Posted on February 1, 2011. Filed under: Neurology | Tags: , |

Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke – Agency for Healthcare Research & Quality [US] – research begun 20 Feb 2010, technical brief published 18 January 2011

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Supporting life after stroke: A review of services for people who have had a stroke and their carers – Care Quality Commission (UK) – January 2011

Posted on January 18, 2011. Filed under: Neurology | Tags: , , |

Supporting life after stroke: A review of services for people who have had a stroke and their carers – Care Quality Commission (UK) – January 2011

“Stroke can be a devastating and life changing event for people. However, our review found that the extent to which they are supported to cope with life after stroke varies significantly across England. The best services are built around the individual – with their care being planned to take account of the needs, circumstances and preferences of the person who has had a stroke, their carers and family. People in these areas are more likely to experience a smooth and coordinated return home from hospital and to have access to a broad range of services to help them recover from, and cope with, the effects of stroke.”

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Insights from stroke survivors and providers of stroke care in rural England: Summary report – Commission for Rural Communities – 20 December 2010

Posted on January 14, 2011. Filed under: Neurology, Rural Remote Health | Tags: , |

Insights from stroke survivors and providers of stroke care in rural England: Summary report – Commission for Rural Communities – 20 December 2010

“This summary report traces the ‘care pathway’ that stroke sufferers typically follow in rural areas– from emergency care, through acute and rehabilitative care in hospital, to care received afterpatients return home.

Concern for the adequacy of service delivery in a rural context has been a major theme of thework of the Commission for Rural Communities (CRC) and its predecessor bodies for manyyears – not least because in any survey of rural people accessibility to services always figures asa major concern.

This report provides insights from users and providers about both the delivery of stroke-related services in England and the challenge that rurality poses for those services. By examining how living in a rural area affects stroke patients’ experiences, this summary is a first stage in tacklingproblems of access.”

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Cost of caring for stroke patients double that of earlier estimates, [Canadian] study finds – 8 June 2010

Posted on June 11, 2010. Filed under: Neurology | Tags: |

Cost of caring for stroke patients double that of earlier estimates, study finds

“Quebec City – Health-care costs for patients in just the first six months after they have a stroke is more than $2.5 billion a year in Canada, according to a study presented today at the Canadian Stroke Congress.

The Canadian Stroke Network’s Burden of Ischemic Stroke (BURST) study found that the direct and indirect health-care costs for new stroke patients tally an average $50,000 in the six-month period following a new stroke. There are about 50,000 new strokes in Canada each year.

Earlier and widely quoted estimates, based on the most recent data from Health Canada’s Economic Burden of Illness (1998), indicated that the total cost of stroke in Canada was $2.4 billion a year for both new stroke patients and long-term survivors. There are 300,000 people living with stroke in Canada.

“Our old estimates of how much stroke costs the economy are way off base,” says Dr. Mike Sharma, who together with Dr. Nicole Mittman of Sunnybrook Health Sciences Centre, led the BURST study, which is the first prospective national economic analysis on stroke costs.

“The cost of stroke is far more than we expected – at least double previous estimates.”

BURST researchers examined the health-care costs of 232 hospitalized stroke patients in 12 sites across Canada at discharge, three months, and six months, and one year. The study looked at both disabling and non-disabling stroke.

Hospitalization, medication, physician services, diagnostic imaging, homecare and rehabilitation all contribute to the bill. There are also indirect costs, including disability leave, lost wages, assisted devices, caregivers, and out-of-pocket expenses for families such as personal assistance products or changes to homes to accommodate disabilities.”

…continues on the website

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[UK] Department of Health: Progress in improving stroke care – National Audit Office – 3 February 2010

Posted on February 9, 2010. Filed under: Health Systems Improvement, Neurology | Tags: , , |

UK] Department of Health: Progress in improving stroke care – National Audit Office – 3 February 2010

HC: 291, 2009-10
ISBN: 9780102963441

* Executive summary (PDF – 139KB)
* Full report (PDF – 958KB)
* Press notice (HTML)
* Methodology (PDF – 69KB)
* Progress In Improving Stroke Care: A Good Practice Guide (PDF – 516KB)

“Care for people who have had a stroke has significantly improved since we reported in 2005. The publication and early implementation of the stroke strategy have begun to make a real difference and have helped to put in place the right mechanisms to bring about these improvements. There is still work to be done though: the poorer performers must be dragged up to the same standard as the best, so that the gains that have been made are sustained and value for money improved further. The Department should focus on ensuring that health, social care and employment services are working together much more effectively.”

Amyas Morse, Head of the National Audit Office, 3 February 2010

“The Department of Health’s strategy for stroke care has increased the priority and awareness of the condition and started to improve patients’ care and outcomes, concludes a report by the National Audit Office published today. Actions taken since 2006 have improved the value for money of stroke care; but improvements have not been universal and improvements in follow-up care have not matched those of acute care services.

The National Stroke Strategy is a comprehensive response to the concerns raised by the NAO in its 2005 report on stroke. The strategy has been underpinned by strong national leadership and performance indicators as well as £59 million of central funding over the first two years, £30 million of which was allocated to local authorities specifically to provide support services to stroke patients and their carers. With this clear focus from Ministers and the Department, the NHS is now starting to deliver better care from stroke services, and outcomes for patients are also improving. The NAO estimates that stroke patients’ chances of dying within ten years have reduced from 71 to 67 per cent since 2006.

Patients treated in a specialist stroke unit are more likely to survive, have fewer complications and regain their independence, and all relevant hospitals in England now have such a unit, although the services provided and time spent in the unit vary. Stroke patients should be immediately admitted to a specialist stroke unit; however in 2008 only 17 per cent of stroke patients reached the stroke unit within four hours of arrival at hospital. Brain imaging is also very important for stroke patients but many patients are not given a scan quickly enough and access at weekends and evenings is significantly more limited.

There is better awareness of the symptoms of stroke, and that it is a medical emergency, following the Department’s ‘Stroke: Act FAST’ advertising campaign, launched in February 2009. The number of calls categorised as being a suspected stroke during April to June 2009 increased by 54 per cent in comparison with the same period in 2008.

However, health and social care services are not working as well together as they could. A third of patients are not getting a follow-up appointment within six weeks and only a half of stroke survivors in the NAO’s survey said that they were given advice on further stroke prevention when leaving hospital.”

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Emergency department stroke and transient ischaemic attack care bundle – NHMRC – 9 December 2009

Posted on December 10, 2009. Filed under: Emergency Medicine, Neurology | Tags: , , , |

Emergency department stroke and transient ischaemic attack care bundle – NHMRC – 9 December 2009

“Improving the management of acute stroke and transient ischaemic attack (TIA) in the emergency department (ED) was identified as a priority by the NICS emergency care community of practice (EC CoP).

In response, NICS initiated a project to develop a set of evidence-based resources to improve the implementation of guideline recommendations for acute stroke and TIA management in the ED.”  … continues on the website

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